Social Networking for Public Health

By Jo Lynn Orr

Why do some children from urban neighborhoods flourish as they grow up, while others fall victim to risky health behaviors? To answer that question, a new UAB initiative is targeting areas impacted by the “urban health penalty”—city districts that experience a greater prevalence of health problems than suburban and rural communities.

The Community Influences Transitions for Youth (CITY) Health Project is investigating resilience, risk, and behavioral health in “emerging adults” aged 15 to 24 years old. Spearheaded by the Center for the Study of Community Health’s Prevention Research Center, the project marks a research shift for the prevention center from the rural Black Belt region of Alabama to urban communities in Birmingham.

“Usually, prevention efforts target the very young,” says Jalie Tucker, Ph.D., M.P.H., professor and chair of the Department of Health Behavior and principal investigator on the CITY Health Project. “But scientists now know that, barring severe traumatic events, humans evolve and grow until death. We think emerging adults are at a juncture where both positive and negative behaviors can get laid down for a lifetime.”

Public health programs aimed at young people are typically based in schools, says Tucker. But emerging adults have often left the school system—and they are difficult to reach through traditional study methods such as surveys. So CITY Health is using an innovative strategy borrowed from HIV/AIDS outreach efforts to tap into the social networks of at-risk populations. It’s called “respondent-driven sampling,” says Cathy Simpson, Ph.D., associate professor of health behavior and member of the project’s research team.

“You start with a certain number of ‘seeds’—a handful of known contacts within the population that you want to target—who are given coupons redeemable for cash or some other form of payment and asked to recruit three to five more people ‘like themselves’ who are not blood relatives,” Simpson says. This process is repeated in waves until researchers create “a network of people who not only are enrolled in the study, but who also are given incentives to recruit other like-minded peers.”

With that information in hand, Tucker says, researchers can gain insight into the social network’s “natural leaders” and tap them as conduits to spread peer-driven public health messages—whether it is the dangers of smoking and substance misuse or the value of exercise and good nutrition.